Presque Isle Retriever Club

Member Application

Name *

Address *

City *

State *

Zip Code *

Email address *

Phone Number *

Dog Breed/Name/Age *

Membership Type *

Annual - $30 (Includes whole family)

Practice Availability

Membership Agreement
By selecting SEND, I agree to support the goals of the Presque Isle Retriever Club, to follow club rules and AKC regulations, and to respect all members, dogs, and training grounds.

Payment Information
• Make checks payable to: Presque Isle Retriever Club

Send to Bob Samios at 1622 Lakeview St. Jamestown, PA 16134

OR

Bring payment to any club training day or event